A holistic approach gives the mind its due.

Emerging formulas for success involve integrating many different medical settings of care — hospitals, physician practices, post-acute services, community-based care — and also arranging for varied types of clinicians to collaboratively address people’s diseases and health habits. Theoretically that will catch and cure problems early, keep complications of chronic illness down and lower the cost of being on the hook for the health of defined populations under performance-based, per-person reimbursement. But the whole person includes not just the body, but the mind. The implications of behavioral health can be significant to reform aimed at reorganizing the environment of care, experts say. If the largely body-focused strategies for patientcentered care and close coordination of providers do not also seek to incorporate treatment of mental illness and substance abuse, the ultimate ability to control costs and influence health will be compromised. “There’s been growing recognition that the failure to treat underlying mental illness and substance abuse, when folks have heart disease or diabetes or other chronic health conditions, complicates chronic illness and makes it more expensive,” said Charles Ingoglia, senior vice president of public policy and practice improvement with the National Council for Community Behavioral Healthcare in Washington, D.C. The challenges begin at the primary care practice level. Doctors there are faced with being the sole treatment source for more than a third of all behavioral health disorders,1 and 80 percent of people with such disorders will visit a primary care practice at least once a year.2 These disorders also present time-consuming and difficult situations for emergency departments, and the incidence of these co-occurring disorders among people hospitalized with medical conditions can lead to higher readmission rates. When behavioral patients are referred to appropriate mental health or substance abuse care, they don’t make their first appointment 30 to 50 percent of the time.3 Two-thirds of people with a behavioral health disorder don’t get treatment at all.4 To keep behavioral problems from offsetting the best laid plans of accountable care, providers A Holistic Approach Gives the Mind Its Due